J.K. v. State of Alaska ( 2020 )


Menu:
  •                                                NOTICE
    The text of this opinion can be corrected before the opinion is published in the
    Pacific Reporter. Readers are encouraged to bring typographical or other formal
    errors to the attention of the Clerk of the Appellate Courts:
    303 K Street, Anchorage, Alaska 99501
    Fax: (907) 264-0878
    E-mail: corrections @ akcourts.us
    IN THE COURT OF APPEALS OF THE STATE OF ALASKA
    J.K.,
    Court of Appeals No. A-13372
    Petitioner,             Trial Court No. 1JU-18-00238 CR
    v.
    OPINION
    STATE OF ALASKA,
    Respondent.                  No. 2670 — July 17, 2020
    Petition for Review from the District Court, First Judicial
    District, Juneau, Kirsten Swanson, Judge.
    Appearances: Renee McFarland, Assistant Public Defender,
    and Beth Goldstein, Acting Public Defender, Anchorage, for the
    Petitioner. Nancy R. Simel, Assistant Attorney General, Office
    of Criminal Appeals, Anchorage, and Kevin G. Clarkson,
    Attorney General, Juneau, for the Respondent.
    Before: Allard, Chief Judge, and Wollenberg and Harbison,
    Judges.
    Judge ALLARD.
    A criminal defendant is incompetent to stand trial when, as a result of a
    mental disease or defect, the defendant is “unable to understand the proceedings against
    the defendant or to assist in the defendant’s own defense.”1 It is a violation of due
    process to try a defendant who is incompetent to stand trial.2 When a defendant has been
    found to be incompetent, the trial court is required to stay the criminal proceedings.3
    Under AS 12.47.110(a), a trial court has the authority to commit an incompetent
    defendant “to the custody of the commissioner of health and social services” for up to
    90 days in an effort to restore the defendant to competency. This initial commitment
    period is mandatory in all felony cases but discretionary in misdemeanor cases.4
    The only facility that currently provides competency restoration treatment
    in the State of Alaska is the Alaska Psychiatric Institute (API), which is administered by
    the Department of Health and Social Services. For some time, API has had significant
    capacity issues, with only ten beds available in their forensic unit. As a result, waitlists
    have developed, and incompetent defendants who have been committed for competency
    restoration are instead remaining in jail for long periods of time awaiting transfer to API.
    1
    AS 12.47.100(a); see also Dusky v. United States, 
    362 U.S. 402
    , 402 (1960) (per
    curiam) (holding that the constitutional standard for competency to stand trial is whether the
    defendant has “sufficient present ability to consult with his lawyer with a reasonable degree
    of rational understanding — and whether he has a rational as well as factual understanding
    of the proceedings against him”).
    2
    See, e.g., Medina v. California, 
    505 U.S. 437
    , 439 (1992); Diggs v. State, 
    274 P.3d 504
    , 505 (Alaska App. 2012).
    3
    AS 12.47.110(a) (“When the trial court determines by a preponderance of the
    evidence, in accordance with AS 12.47.100, that a defendant is so incompetent that the
    defendant is unable to understand the proceedings against the defendant or to assist in the
    defendant’s own defense, the court shall order the proceedings stayed . . . .”).
    4
    AS 12.47.110(a).
    –2–                                          2670
    These delays in obtaining competency restoration treatment raise serious due process
    concerns.5
    The current case involves an incompetent defendant, J.K.,6 who was
    charged with a misdemeanor and committed to the custody of the Department of Health
    and Social Services for competency restoration treatment under a 90-day commitment
    order. J.K. was placed on a waitlist and remained in jail pending admission to API.
    When it became clear that the 90-day order was likely to expire before J.K. could be
    transferred to API, J.K.’s defense attorney moved to dismiss the case in the furtherance
    of justice. The district court denied this motion. Later, after the 90-day order expired
    — with J.K. still in jail and still on API’s waitlist — J.K.’s defense attorney moved a
    second time to dismiss the case. This time, the attorney argued that J.K.’s right to
    substantive due process under Jackson v. Indiana7 was being violated by the delay in
    receiving treatment and that the proper remedy for this constitutional violation was
    dismissal without prejudice. At the urging of the prosecutor, however, the trial court
    entered a second 90-day commitment order and ultimately denied the motion to dismiss.
    In response, J.K.’s attorney filed a petition to this Court, seeking immediate
    review of the trial court’s ruling. Instead of filing a response to the petition, the State
    responded by dismissing J.K.’s case without prejudice under Alaska Criminal Rule
    43(a)(1). Although J.K.’s case was now moot, we granted the petition under the public
    interest exception to the mootness doctrine.8 We now hold that the prolonged delay in
    5
    See Jackson v. Indiana, 
    406 U.S. 715
     (1972).
    6
    We use initials to protect J.K.’s privacy.
    7
    Jackson v. Indiana, 
    406 U.S. 715
     (1972).
    8
    See State v. Roberts, 
    999 P.2d 151
    , 153 (Alaska App. 2000) (“The public interest
    exception requires the consideration of three main factors: (1) whether the disputed issues
    (continued...)
    –3–                                        2670
    obtaining competency restoration treatment violated J.K.’s right to substantive due
    process and required dismissal without prejudice of J.K.’s criminal case.
    Factual background
    In March 2018, J.K. was arrested and charged with fourth-degree fear
    assault, a misdemeanor.9 The charge was based on an incident at a Juneau restaurant in
    which J.K. allegedly approached another patron and threatened her with a butter knife.
    At arraignment, it was clear that J.K. had serious mental health issues; the court
    questioned whether “there might be a Title 47 issue” and stated that “in an abundance of
    caution,” it would require a “Title 47” before J.K.’s release — a consideration that was
    never addressed again.
    (Title 47 governs the civil commitment of persons who are mentally ill and,
    as a result of that condition, are likely to cause harm to themselves or others, or are
    8
    (...continued)
    are capable of repetition, (2) whether the mootness doctrine, if applied, may cause review of
    the issues to be repeatedly circumvented, and (3) whether the issues presented are so
    important to the public interest as to justify overriding the mootness doctrine.” (quoting
    Krohn v. State Dep’t. of Fish & Game, 
    938 P.2d 1019
    , 1021 (Alaska 1997))).
    9
    AS 11.41.230(a)(3). J.K. was initially charged with third-degree assault (AS 11.-
    41.220(a)(1)(A)), which was reduced to fourth-degree assault at arraignment.
    –4–                                          2670
    gravely disabled.10 This civil procedure for involuntary commitment is independent from
    any criminal proceedings that may have been instituted.11)
    J.K. was appointed an assistant public defender. The assistant public
    defender filed an unopposed motion for a competency evaluation, which was granted by
    the court. By the time the evaluation was submitted (approximately three weeks after the
    60-day deadline set by the court), J.K. had already been in custody for 143 days.
    The forensic psychologist who conducted the evaluation, Dr. Dianna Rehn,
    had difficulties with the evaluation. J.K. is Korean and has limited proficiency in
    English. Dr. Rehn attempted to interview J.K. twice — the second time with an
    interpreter — but J.K. was continually shouting at the interpreter. The interpreter also
    stated that J.K. was speaking an “atypical” form of Korean that was mostly “gibberish.”
    10
    See AS 47.30.700-.915 (authorizing involuntary commitment pursuant to specified
    procedures for those persons who are “mentally ill” and, as a result, are “gravely disabled”
    or “likely to cause serious harm” to themselves or others); see also AS 47.30.915(9)(B)
    (defining “gravely disabled” as “a condition in which a person as a result of mental illness
    will, if not treated, suffer or continue to suffer severe and abnormal mental, emotional, or
    physical distress, and this distress is associated with significant impairment of judgment,
    reason, or behavior causing a substantial deterioration of the person’s previous ability to
    function independently”); AS 47.30.915(12)(A),(B) (defining “likely to cause serious harm”
    as posing “a substantial risk of bodily harm to that person’s self, as manifested by recent
    behavior causing, attempting, or threatening that harm” or “a substantial risk of harm to
    others as manifested by recent behavior causing, attempting, or threatening harm, and is
    likely in the near future to cause physical injury, physical abuse, or substantial property
    damage to another person”); AS 47.30.915(14) (defining “mental illness” as “an organic,
    mental, or emotional impairment that has substantial adverse effects on an individual’s ability
    to exercise conscious control of the individual’s actions or ability to perceive reality or to
    reason or understand”).
    11
    In re Hospitalization of Linda M., 
    440 P.3d 168
    , 173 (Alaska 2019) (noting that
    incompetency to stand trial and mental illness for purposes of civil commitment coexist and
    that commitment to treat these two conditions may be sequential, concurrent, or overlap if
    each is independently justified).
    –5–                                           2670
    Dr. Rehn reported that J.K. was not doing well in custody and that he had
    been transferred to the jail’s acute mental health unit. J.K. was noncompliant with his
    psychotropic medications and was exhibiting bizarre behavior, including walking around
    naked, reacting to internal stimuli, speaking gibberish, and barking. J.K. refused to
    shower and was “malodorous.” He had also developed an eye infection after placing his
    fingers in his rectum and then in his eye. J.K. refused any treatment for this eye
    infection.
    Dr. Rehn diagnosed J.K. with “an unspecified schizophrenia spectrum or
    other psychotic disorder,” and she concluded that he was incompetent to stand trial —
    that is, she found that J.K. lacked the capacity to understand the proceedings against him
    or to assist in his own defense.12 The doctor opined that treatment with psychiatric
    medications would “likely improve [J.K.’s] symptoms,” but it was “unclear [if] this
    improvement would restore [J.K.] to competency.” Dr. Rehn further opined that it was
    “highly unlikely” that J.K. could be restored to competency if he continued to be
    noncompliant with his psychotropic medications. She also noted that restoration services
    were likely to be made more difficult by J.K.’s limited English.
    A status hearing regarding the competency evaluation was held on August
    14, 2018. By the time of the hearing, J.K. had already served 149 days in custody.
    At the hearing, the trial court found J.K. incompetent to stand trial, and the
    court ordered J.K. to be committed to API for competency restoration treatment under
    AS 12.47.110(a). The trial court acknowledged that it was not required to order
    competency restoration treatment in J.K.’s case because he was only charged with a
    12
    AS 12.47.100(a) (defining incompetency to proceed as when a defendant, “as a result
    of mental disease or defect, . . . is unable to understand the proceedings against the defendant
    or to assist in the defendant’s own defense”).
    –6–                                           2670
    misdemeanor.13 But the court justified its decision to order treatment on the ground that
    J.K. would likely be a danger to himself and to others if released or, “at the very least,
    gravely disabled.” The court did not address the possibility of a dismissal without
    prejudice and civil commitment under Title 47.
    The trial court committed J.K. to the custody of the Department of Health
    and Social Services (the department that administers API) for a period not to exceed 90
    days. The written order was signed the day after the hearing — on August 15 — and
    distributed on August 21.
    On September 6, API notified the court that its forensic beds were full and
    that J.K. was number twenty-six on the waitlist. API further informed the court that it
    was “likely” that the delay in admitting J.K. to API would account for “most, if not all”
    of the 90-day commitment order. During the delay, J.K. would remain in jail without
    any competency restoration treatment.
    The trial court held a status hearing on September 12 to discuss the delay
    in obtaining treatment. The defense attorney noted that J.K. was only charged with a
    misdemeanor, that he had already been in custody for almost six months, and that there
    was a low likelihood that he was even restorable to competency. The trial court agreed
    that the forensic report indicated that Dr. Rehn “didn’t really have a high level of
    confidence that things were going to improve,” and, in fact, “[J.K.] was getting
    13
    See AS 12.47.110(a) (“When the trial court determines by a preponderance of the
    evidence, in accordance with AS 12.47.100, that a defendant is so incompetent that the
    defendant is unable to understand the proceedings against the defendant or to assist in the
    defendant’s own defense, the court shall order the proceedings stayed, . . . and shall commit
    a defendant charged with a felony, and may commit a defendant charged with any other
    crime, to the custody of the commissioner of health and social services or the commissioner’s
    authorized representative for further evaluation and treatment until the defendant is mentally
    competent to stand trial, or until the pending charges against the defendant are disposed of
    according to law, but in no event longer than 90 days.” (emphasis added)).
    –7–                                          2670
    progressively worse.” The court called API to help “decide where [to] go for [J.K.] at
    this point,” and it scheduled another hearing on the matter for the following week.
    The next day, on September 13, J.K.’s defense attorney filed a motion to
    dismiss under Alaska Criminal Rule 43(c). Criminal Rule 43(c) grants trial courts
    limited authority to dismiss criminal cases in “furtherance of justice.”14 The defense
    attorney argued that dismissal of J.K.’s charge was the appropriate remedy given the
    delay that had already occurred, the delay that was anticipated to occur, and the amount
    of time J.K. had already spent in custody. The defense attorney pointed out that the
    maximum penalty for a class A misdemeanor is one year and that J.K. would likely have
    served that time by the time he was admitted to API.
    The State filed an opposition to J.K.’s motion to dismiss, arguing that there
    was no injustice because delay was a normal part of the process. According to the
    prosecutor, “[i]t does not work an injustice to the defendant if the [statutory] procedure
    [of determining a defendant’s competency to stand charges and restoring him to
    competency] is followed, regardless of the status of negotiations or the length of time
    [J.K.] may face if convicted of this crime.”
    The next status hearing was held on November 6. At that hearing, the
    defense attorney inquired when the trial court would rule on the pending motion to
    dismiss and noted that J.K. had been in custody for 233 days — “nine days away from
    14
    The exercise of a trial court’s discretion under Alaska Criminal Rule 43(c) can be with
    or without prejudice depending on the circumstances. Cf. AS 12.47.110(b) (ordering
    dismissal of charges without prejudice at the end of specified commitment periods); Jordan
    v. State, 
    407 P.3d 499
    , 501 (Alaska App. 2017) (explaining that Criminal Rule 43(a)(1),
    authorizing dismissal of charges by the prosecuting attorney, was “addressed to dismissals
    without prejudice” (emphasis removed)).
    –8–                                          2670
    a year with good time.”15 The trial court explained that it still needed more information,
    and it again called API for an update regarding J.K.’s status on the waitlist. A
    representative from API stated that J.K. was now number eight on the waitlist, but the
    representative still could not say when J.K. would actually be admitted for competency
    restoration treatment.
    The trial court expressed its discomfort with “keeping [J.K.] in limbo
    forever,” but did not rule on the pending motion to dismiss at that time. Instead, the
    court scheduled another status hearing the following week for the parties to make oral
    arguments.
    At that hearing, held November 14, the defense attorney asked the court to
    rule on the pending motion to dismiss, pointing out that J.K. had already spent 241 days
    incarcerated, and that API still could not guarantee his admission within any specific
    time period.
    The prosecutor argued (erroneously) that the court had no authority to
    dismiss the case. The prosecutor acknowledged that “the status quo right now is
    certainly not the best of all worlds,” but she asserted that continued detention in jail is
    “a better option in terms of safety to [J.K.], safety to the community, than the alternative
    which is to release him with absolutely no plan and no safeguards in place to protect him
    and the community.” The trial court again expressed frustration that J.K. was sitting in
    jail and likely “getting worse,” but questioned whether “cutting him loose does a lot of
    good.” The option of seeking civil commitment under Title 47 was again not mentioned
    or discussed.
    15
    See AS 33.20.010(a) (explaining the good time calculation, where a defendant
    “sentenced to a term of imprisonment that exceeds three days is entitled to a deduction of
    one-third of the term of imprisonment rounded off to the nearest day if the prisoner follows
    the rules of the correctional facility in which the prisoner is confined”).
    –9–                                         2670
    Two days later, on November 16, the trial court summarily denied J.K.’s
    motion to dismiss in a written order. The trial court later explained that it had denied the
    motion “in part because we didn’t really have a place for [J.K.] to go.”
    Ten days later, on November 26, J.K.’s defense attorney filed a second
    motion to dismiss. The motion cited to Jackson v. Indiana, and asserted that J.K.’s
    continued detention due to the limited capacity at API violated his right to substantive
    due process under the state and federal constitutions.16 The motion also cited to multiple
    cases from other jurisdictions in which courts had held that similar lengthy delays violate
    substantive due process.17 The motion contended that the remedy for the constitutional
    violation was dismissal of the case without prejudice.
    The prosecutor filed an opposition to the second motion to dismiss,
    reiterating her argument that the process of determining J.K.’s competency to stand trial
    and restoring him to competency “contemplates a delay.” The prosecutor did not
    respond to the constitutional arguments made in the second motion to dismiss; nor did
    she address the out-of-state authority cited in the motion.
    16
    See Jackson v. Indiana, 
    406 U.S. 715
    , 738 (1972) (“At the least, due process requires
    that the nature and duration of commitment bear some reasonable relation to the purpose for
    which the individual is committed.” (emphasis added)); see also Oregon Advocacy Ctr. v.
    Mink, 
    322 F.3d 1101
    , 1122 (9th Cir. 2003) (applying Jackson to restorative competency
    services to hold that substantive due process prohibits the state from detaining “incapacitated
    criminal defendants in jail for weeks or months . . . because the nature and duration of their
    incarceration bear no reasonable relation to the evaluative and restorative purposes for which
    courts commit those individuals”).
    17
    See, e.g., Trueblood v. Washington State Dep’t of Soc. & Health Servs., 
    822 F.3d 1037
    (9th Cir. 2016); Mink, 
    322 F.3d 1101
    ; Disability Law Ctr. v. Utah, 
    180 F. Supp. 3d 998
     (D.
    Utah 2016); Terry ex rel. Terry v. Hill, 
    232 F. Supp. 2d 934
     (E.D. Ark. 2002); Powell v.
    Maryland Dep’t of Health, 
    168 A.3d 857
     (Md. 2017); Lakey v. Taylor, 
    435 S.W.3d 309
     (Tex.
    App. 2014); State v. Hand, 
    401 P.3d 367
     (Wash. App. 2017).
    – 10 –                                        2670
    On December 17, the same day that J.K.’s attorney filed his reply to the
    State’s opposition, the trial court issued an order extending J.K.’s commitment for
    competency restoration treatment for another 90 days.18 The order also directed that a
    status hearing be calendared for January 3, 2019. When that status hearing was not
    calendared, J.K.’s attorney filed another request seeking a ruling on the second motion
    to dismiss.
    But the court did not issue a ruling on the second motion to dismiss.
    Instead, the court held another status hearing on January 23. At this point, J.K. had been
    in custody without access to competency restoration treatment for 311 days.
    At the January 23 hearing, the court indicated that it intended to deny the
    second motion to dismiss, but that it also intended to make sure that J.K. was not held
    for longer than 365 days — the maximum sentence for a class A misdemeanor.
    On January 29, 2019, the trial court entered two orders. The first order
    reiterated the December 17 order committing J.K. “for another 90 days for a competency
    restoration program.” But the order also made clear that the commitment would end on
    March 18, 2019, the date by which J.K. would have been in custody for 365 days. The
    second order denied J.K.’s second motion to dismiss, noting that J.K. was now number
    two on the waitlist. The order also directed J.K. to be released from custody if he was
    not restored to competency by March 18, 2019.
    On February 1, 2019, J.K.’s defense attorney filed an expedited petition for
    review with this Court. This Court granted expedited consideration of the petition and
    ordered the State to respond on an expedited basis. In response, the State initiated civil
    commitment proceedings against J.K. under Title 47 and dismissed J.K.’s criminal case
    without prejudice, thereby rendering this case moot.
    18
    See AS 12.47.110(b).
    – 11 –                                     2670
    This Court granted J.K.’s petition for review under the public interest
    exception to the mootness doctrine. This decision now follows.
    Substantive due process and the rights of criminal defendants who have
    been found incompetent to stand trial
    Under AS 12.47.110(a), a trial court has the authority to commit an
    incompetent defendant “to the custody of the commissioner of health and social services”
    for up to 90 days in an effort to restore the defendant to competency. As previously
    mentioned, this initial commitment period is mandatory in all felony cases but
    discretionary in misdemeanor cases.19
    This initial 90-day commitment may be extended, at the trial court’s
    discretion, for another 90 days, provided that the defendant is improving and there is
    good reason to believe that the defendant will probably soon be able to stand trial.20 If
    the defendant has not regained competency at the expiration of the second 90-day
    commitment order, the trial court is required to dismiss the case without prejudice —
    except in cases where the defendant is charged with a crime involving force against a
    person.21 If the defendant is charged with a crime involving force against a person, the
    trial court retains the discretion to extend the commitment for an additional six months,
    provided the court finds that: (1) “the defendant presents a substantial danger of physical
    19
    AS 12.47.110(a).
    20
    See AS 12.47.110(b); Jackson v. Indiana, 
    406 U.S. 715
    , 738 (1972) (explaining that,
    when a criminal defendant is committed on the basis of incompetency to stand trial, it must
    be “determined that the defendant probably soon will be able to stand trial”).
    21
    AS 12.47.110(b).
    – 12 –                                      2670
    injury to other persons”; and (2) “there is a substantial probability that the defendant will
    regain competency within a reasonable period of time.”22
    As a matter of substantive due process, an incompetent defendant may not
    be held “more than the reasonable period of time necessary to determine whether there
    is a substantial probability that he will attain that capacity in the foreseeable future.”23
    In other words, due process requires that a defendant be committed for competency
    restoration treatment only when there is good reason to believe that the treatment is likely
    to restore the defendant to competency in the near future.24 “If it is determined that this
    is not the case, then the State must either institute the customary civil commitment
    proceeding that would be required to commit . . . any other citizen, or release the
    defendant.”25
    Due process also requires that “the nature and duration of commitment bear
    some reasonable relation to the purpose for which the individual is committed.”26 Thus,
    22
    
    Id.
    23
    Jackson, 
    406 U.S. at 738
    .
    24
    See Powell v. Maryland Dep’t of Health, 
    168 A.3d 857
    , 874 (Md. 2017) (“If the
    defendant is not restorable — i.e., not likely to become competent within the foreseeable
    future — the government must either release the defendant or institute civil commitment
    proceedings.”).
    25
    Jackson, 
    406 U.S. at 738
    .
    26
    
    Id.
     Due process governs other aspects of an incompetent defendant’s treatment as
    well. For instance, if the competency restoration treatment includes forced medication, the
    defendant is entitled to a hearing under Sell v. United States, 
    539 U.S. 166
     (2003). An
    incompetent defendant may not be forcibly medicated unless the court specifically finds that
    (1) important governmental interests are at stake; (2) involuntary medication will
    significantly further those important governmental interests; (3) involuntary medication is
    necessary to further those interests; and (4) administration of the drugs is medically
    (continued...)
    – 13 –                                       2670
    “even if it is determined that the defendant probably soon will be able to stand trial, his
    continued commitment must be justified by progress toward that goal.”27 In other words,
    a defendant who has been found incompetent and committed to competency restoration
    treatment cannot languish in jail without access to the treatment.28 Instead, defendants
    are entitled to a “reasonably timely” transfer to the facility that provides competency
    restoration treatment.29
    26
    (...continued)
    appropriate, i.e., in the patient’s best medical interest in light of his or her mental condition.
    Sell, 
    539 U.S. at 180-82
    .
    27
    Jackson, 
    406 U.S. at 738
    ; see Carr v. State, 
    815 S.E.2d 903
    , 912 (Ga. 2018) (“No
    matter how short the duration of the detention, if the nature of the confinement is not
    reasonably related to the government’s purpose of accurately evaluating the individual
    defendant’s potential to attain competency, the detention is unconstitutional.”).
    28
    See Lakey v. Taylor, 
    435 S.W.3d 309
    , 320 (Tex. App. 2014) (“An incompetent
    defendant’s prolonged detention cannot be ‘justified by progress toward [the goal of restoring
    competency]’ if he is not receiving any competency-restoration treatment.” (alteration in
    original) (citation omitted)). We note that some jurisdictions have concluded that speedy trial
    rights are also implicated by delays in obtaining competency restoration. See, e.g., Craft v.
    Superior Court, 
    140 Cal.App.4th 1533
    , 1545, 
    44 Cal.Rptr.3d 912
    , 920 (Cal. App. 2006)
    (“Because commitment and treatment are the intertwined rationales for suspending criminal
    proceedings against a mentally incompetent defendant, it follows that where there is no
    commitment and no treatment, the time an incompetent defendant spends in jail is
    unnecessary and implicates not only due process, but also counts towards a finding of
    prolonged incarceration under the state constitutional speedy trial guarantee.” (citation
    omitted)). We do not address this question here because it has not been raised.
    29
    Oregon Advocacy Ctr. v. Mink, 
    2002 WL 35578910
    , at *7 (D. Or. May 10, 2002)
    (unpublished), judgment entered, 
    2002 WL 35578888
     (D. Or. May 15, 2002) (unpublished),
    aff’d, 
    322 F.3d 1101
     (9th Cir. 2003), modified, 
    2020 WL 2465331
     (D. Or. May 13, 2020)
    (unpublished) [hereinafter Mink District Order]; see also Powell, 168 A.3d at 874 (“Any
    delay in transferring that defendant to a designated facility pursuant to a commitment order
    must be reasonable in relation to the purpose of treating the defendant while protecting both
    (continued...)
    – 14 –                                         2670
    The only facility that currently provides competency restoration treatment
    in Alaska is the Alaska Psychiatric Institute (API), an in-patient psychiatric facility with
    limited bed space. Unlike other states, Alaska does not have an out-of-custody
    competency restoration program.30 Nor does it have adequate forensic beds to meet the
    demands of the criminal justice system.31
    29
    (...continued)
    the defendant and the public.”).
    30
    W. Neil Gowensmith et al., Lookin’ for Beds in All the Wrong Places: Outpatient
    Competency Restoration as a Promising Approach to Modern Challenges, 22 Psychol., Pub.
    Pol’y & L. 293, 296 & tbl.1 (2016) (providing data from 2014, where 36 states explicitly
    allowed outpatient competency restoration while Alaska explicitly prohibited outpatient
    competency restoration); see also Carr, 815 S.E.2d at 916 (“To ensure that the nature of
    commitment to the department is appropriate for the particular defendant, the court should
    consider all relevant evidence and make a finding as to whether the evaluation required by
    [Georgia’s competency statute] should be conducted on an inpatient or outpatient basis.”);
    id. at 916-17 & n.17 (remanding and requiring the trial court in the first instance to exercise
    discretion “in deciding whether [the defendant] should be committed to the department’s
    custody for evaluation or should be evaluated on an outpatient basis” and instructing the
    court to consider whether the defendant should have been returned to release on bond and
    whether the duration of his detention was unreasonable).
    31
    This systemic problem is the subject of a recent report to the Department of Health
    and Human Services. See Agnew:Beck Consulting Inc., et al, Forensic Psychiatric Hospital
    Feasibility Study, at 5-6 (Feb. 1, 2019) available at http://dhss.alaska.gov/API/Documents/
    AdminChanges/ForensicPsychHospital_FeasibilityStudy_ExecutiveSummary_201907.pdf
    (last visited July 11, 2020) (stating that “Alaska’s forensic system is overloaded” and that
    there is “a need to expand capacity for both competency evaluations and for providing
    treatment for competency restoration”). We note that this capacity problem was foreseen in
    2008 when the legislature amended AS 12.47.110 to make restoration treatment for
    incompetent defendants charged with felonies mandatory. See Minutes of Senate Judiciary
    Comm., Senate Bill 234, testimony of Ron Adler, CEO/Director, API, 2:44:30-2:44:56 p.m.
    (Feb. 29, 2008) (explaining that the proposed provisions of SB 234 “could cause capacity
    issues in the future” and “could result in additional planning for changes in the facility or
    (continued...)
    – 15 –                                        2670
    In the current case, J.K. was charged with a misdemeanor, for which
    commitment under AS 12.47.110(a) is discretionary rather than mandatory. J.K. was
    committed under an initial 90-day order, but he was put on a waitlist and the 90-day
    commitment order expired before he was transferred to API for competency restoration
    treatment. J.K. asserts that the lengthy delay in obtaining competency restoration
    treatment violated his right to substantive due process under the state and federal
    constitutions.32 The State now acknowledges that J.K.’s constitutional rights “may” have
    been violated.
    Courts in other jurisdictions that have confronted similar delays have
    consistently found that such delays violate substantive due process.33 Many of these
    31
    (...continued)
    additional facilities in the state” because “the forensic unit at API is typically full with a
    waiting list”); see also Fiscal Note 8 for SB 265, API, Behavioral Health, Dep’t of Health
    & Soc. Servs. (Apr. 9, 2008) (“[I]f the current trend of increasing admissions to the Alaska
    Psychiatric Institute continues, it will cause capacity issues that may have to be addressed at
    a later date.”).
    32
    See U.S. Const. amend. XIV; Alaska Const. art. I, § 7.
    33
    See, e.g., Terry ex rel. Terry v. Hill, 
    232 F. Supp. 2d 934
    , 944 (E.D. Ark. 2002)
    (holding that the average wait time of over six months for admission into the state hospital
    was “far beyond any constitutional boundary”); Mink District Order, 
    2002 WL 35578910
    ,
    at *3-4, *6 (concluding that a 31.98-day average wait time for transport to the state hospital,
    with delays of up to 166 days, was a violation of due process); State v. Hand, 
    429 P.3d 502
    (Wash. 2018) (holding that the state violated the defendant’s substantive due process rights
    by detaining him for 76 days before providing competency restoration treatment); In re
    Loveton, 
    244 Cal.App.4th 1025
    , 1048, 
    198 Cal.Rptr.3d 514
     (Cal. App. 2016) (holding that
    a trial court’s 60-day transfer deadline for defendants incompetent to stand trial “realistically
    places an outside limit on what is statutorily and constitutionally permissible”); State v.
    Kidder, 
    389 P.3d 664
     (Wash. App. 2016) (affirming the trial court’s dismissal of criminal
    charge without prejudice on statutory and due process grounds when the defendant was not
    transported to the state hospital for restoration treatment until after the 90-day commitment
    (continued...)
    – 16 –                                        2670
    cases involve civil lawsuits brought by or on behalf of mentally incompetent defendants
    who were held in jail for lengthy periods of time awaiting their transfer to the state
    mental hospital for competency restoration treatment.34
    In Oregon Advocacy Center v. Mink, for example, an advocacy center
    brought suit on behalf of mentally incompetent defendants whose transfers to the state
    mental hospital were averaging one month or more.35 A federal district court in Oregon
    concluded that there was “no rationalization that passes constitutional muster for
    unreasonably detaining persons found unfit to proceed in county jails.”36 And the court
    33
    (...continued)
    order expired and when the defendant had been in confinement for 175 days by the time of
    the dismissal).
    34
    See, e.g., Trueblood v. Washington State Dep’t of Soc. & Health Servs., 
    822 F.3d 1037
    (9th Cir. 2016) (plaintiffs in a 
    42 U.S.C. § 1983
     action were members of a class of pretrial
    detainees suspected of being mentally incompetent, next friends of such pretrial detainees,
    and disability rights organization); Oregon Advocacy Ctr. v. Mink, 
    322 F.3d 1101
     (9th Cir.
    2003) (plaintiffs included mentally incapacitated criminal defendant who was detained in a
    county jail while awaiting transfer to state hospital and two nonprofit organizations that
    represent such defendants); Disability Law Ctr. v. Utah, 
    180 F. Supp. 3d 998
     (D. Utah 2016)
    (plaintiffs in putative class action under § 1983 were the Disability Law Center and pretrial
    detainees who had been declared incompetent to stand trial but had not been adjudicated
    guilty of a crime); Advocacy Ctr. for Elderly & Disabled v. Louisiana Dep’t of Health &
    Hosps., 
    731 F. Supp. 2d 603
     (E.D. La. 2010) (plaintiffs were incompetent criminal
    defendants detained pretrial and disability advocacy organization); Terry, 
    232 F. Supp. 2d 934
     (plaintiffs in § 1983 class action were pretrial detainees); In re Loveton, 
    244 Cal.App.4th 1025
     (defendants were detainees who had been found mentally incompetent to stand trial and
    filed consolidated petitions for writ of habeas corpus); Lakey v. Taylor, 
    435 S.W.3d 309
    (Tex. App. 2014) (plaintiffs were Disability Rights Texas and nine pretrial detainees who had
    been found incompetent to stand trial).
    35
    Mink, 
    322 F.3d at 1106
    .
    36
    Mink District Order, 
    2002 WL 35578910
    , at *6; see also Lakey, 
    435 S.W.3d at 320-21
    (continued...)
    – 17 –                                        2670
    further concluded that “[t]he lack of funds, staff or facilities cannot justify defendants’
    failure to provide persons found unfit with the treatment that is necessary to attempt
    restoration of competency.”37 The court ordered that incompetent defendants must be
    admitted to a treatment facility “in a reasonably timely manner” — which the court
    interpreted as no later than seven days after the issuance of an order finding a criminal
    defendant incompetent to stand trial and committing him to restoration treatment.38
    The State of Oregon appealed this ruling to the Ninth Circuit, which
    affirmed the finding of a substantive due process violation and upheld the district court’s
    injunction requiring admission within seven days.39 Drawing support from Jackson v.
    Indiana, the Ninth Circuit explained that “[h]olding incapacitated criminal defendants
    in jail for weeks or months violates their due process rights because the nature and
    duration of their incarceration bear no reasonable relation to the evaluative and
    restorative purposes for which courts commit those individuals.”40
    36
    (...continued)
    (“The lengthy pretrial detention of an incompetent defendant, without any progress at all
    toward the stated goal of competency-restoration treatment, is not rationally related to any
    legitimate governmental interest.”).
    37
    Mink District Order, 
    2002 WL 35578910
    , at *6.
    38
    Id. at *7.
    39
    Mink, 
    322 F.3d at 1122-23
    .
    40
    
    Id. at 1122
    ; see also Advocacy Ctr. for Elderly & Disabled v. Louisiana Dep’t of
    Health & Hosps., 
    731 F. Supp. 2d 603
    , 621 (E.D. La. 2010) (relying on Jackson to hold that
    “the continued imprisonment of the Incompetent Detainees in parish jails . . . does not bear
    a reasonable relationship to either restoring the Detainees to competency or determining that
    they will never become competent”); Lakey, 
    435 S.W.3d at 321
     (“Based on Jackson, we
    agree that an incompetent defendant’s continued detention for competency restoration must
    be justified by progress toward that goal, such that his due-process rights are violated if he
    (continued...)
    – 18 –                                        2670
    A federal district court in Washington reached a similar conclusion in
    Trueblood v. Washington State Dep’t of Soc. & Health Servs.41 In Trueblood, the court
    found “seven days to be the maximum justifiable period of incarceration” allowed by the
    Fourteenth Amendment.42 Following a bench trial, the court concluded that a “seven-day
    limit is required by the Constitution” because holding incompetent defendants in jail
    causes harm that directly conflicts with the goal of competency restoration:
    Each additional day of incarceration causes further
    deterioration of class members’ mental health, increases the
    risks of suicide and of victimization by other inmates, and
    causes illness to become more habitual and harder to cure,
    resulting in longer restoration periods or in the inability to
    ever restore that person to competency.43
    The State of Washington did not appeal this part of the court’s order.44
    40
    (...continued)
    fails to receive any competency-restoration treatment within a reasonable amount of time
    following the court’s entry of the order of commitment.”).
    41
    Trueblood v. Washington State Dep’t of Soc. & Health Servs., 
    101 F. Supp. 3d 1010
    (W.D. Wash. 2015).
    42
    
    Id. at 1022
    .
    43
    Id.; see also Mink District Order, 
    2002 WL 35578910
    , at *4 (“Persons who are found
    unfit to stand trial and remain in jail suffer constitutionally cognizable harm, and are entitled
    to prompt treatment in a rehabilitative facility. Even short periods of incarceration of these
    persons can cause cognizable harm.”).
    44
    The federal district court’s permanent injunction required both initial competency
    evaluations and admission to competency restoration services to occur within seven days of
    a court order. Because the State of Washington only appealed the portion of the injunction
    related to the time limit for the initial competency evaluations, the Ninth Circuit only
    addressed whether due process compelled the State to perform these evaluations within seven
    days of a court order. The Ninth Circuit held that due process required the Department of
    (continued...)
    – 19 –                                         2670
    Although courts have been uniform in finding that lengthy delays in
    obtaining restoration treatment violate an incompetent defendant’s substantive due
    process rights, courts have been varied in their determination of what constitutes a
    “reasonable” delay in transferring an incompetent defendant to a mental health facility.
    As already mentioned, federal district courts in Oregon and Washington have set the
    deadline at seven days. However, other courts have set deadlines of twenty-one days and
    thirty days.45
    44
    (...continued)
    Social and Health Services to “conduct competency evaluations within a reasonable time
    following a court’s order,” but that the “district court’s seven-day mandate . . . impose[d] a
    temporal obligation beyond what the Constitution requires.” Trueblood v. Washington State
    Dep’t of Soc. & Health Servs., 
    822 F.3d 1037
    , 1040 (9th Cir. 2016).
    45
    See, e.g., Advocacy Ctr. for Elderly & Disabled, 
    731 F. Supp. 2d at 627
     (issuing, after
    an evidentiary hearing, a preliminary injunction setting a 21-day transfer); see also Cooper
    v. Kliebert, 
    2016 WL 3892445
     (M.D. La. July 18, 2016) (unpublished) (denying Louisiana
    Department of Health and Hospital’s motion to dismiss plaintiffs’ complaint arising out of
    similar litigation to Advocacy Ctr. for Elderly & Disabled, while noting that the prior
    litigation in Advocacy Ctr. had later resulted in a consent decree that set a 30-day deadline
    for admission to the state hospital).
    – 20 –                                        2670
    Some courts have been reluctant to set precise deadlines.46 In Terry, by and
    through Terry v. Hill, for example, a federal district court in Arkansas concluded that
    delays that averaged over six months for defendants awaiting treatment violated
    substantive due process.47 The court had heard testimony that the state hospital was in
    “crisis” because the number of competency referrals had increased and the hospital’s
    ability to admit patients had decreased due to limited funding, space, and staffing.48 The
    court concluded that “[t]he lengthy and indefinite periods of incarceration, without any
    legal adjudication of the crime charged, caused by the lack of space at [the state hospital],
    is not related to any legitimate goal, is purposeless and cannot be constitutionally
    inflicted upon the members of the class.”49 The court deferred consideration of “what
    length of wait is constitutionally permissible,” but it noted that “the length of wait
    experienced by inmates today is far beyond any constitutional boundary.”50
    46
    See, e.g., Powell v. Maryland Dep’t of Health, 
    168 A.3d 857
    , 876 (Md. 2017) (“While
    the due process clause sets some outside constraints, a one-size fits all approach is unlikely
    to be reasonable.”); see also State v. Hand, 
    429 P.3d 502
    , 506-07 (Wash. 2018), aff’g 
    401 P.3d 367
     (Wash. App. 2017) (holding that the state hospital’s 61-day delay in admitting
    defendant for competency restoration treatment was unreasonable and violated substantive
    due process rights without commenting on general reasonableness standard); In re Loveton,
    
    244 Cal.App.4th 1025
    , 1043-44, 1047 n.19, 
    198 Cal.Rptr.3d 514
     (Cal. App. 2016) (affirming
    the trial court’s 60-day deadline, which the court had found “constitutes a reasonable time
    to effectuate a transfer from the county jail to a state mental hospital for evaluation and
    treatment,” but limiting the order to that particular case and noting the “piecemeal nature of
    countywide standing orders”).
    47
    Terry ex rel. Terry v. Hill, 
    232 F. Supp. 2d 934
    , 938, 943 (E.D. Ark. 2002).
    48
    
    Id. at 937-38
    .
    49
    
    Id. at 943-44
    .
    50
    
    Id. at 944
    .
    – 21 –                                        2670
    Our resolution of this case
    In the current case, J.K. requests that we find that the more than 100-day
    delay that he experienced violated his right to substantive due process.51 He also requests
    that we set a presumptive deadline of ten days for transferring incompetent defendants
    who have been committed for restoration treatment to API. J.K. argues that setting a
    presumptive deadline of ten days will ensure that most defendants are transferred on a
    timely basis but will provide for flexibility if unusual circumstances prevent a timely
    transfer in a particular case. The State opposes the setting of any presumptive deadline.
    It argues that further factual development regarding current changes to API’s operations
    and its attempts to reduce its waitlist is needed before a presumptive deadline can be set.
    We agree with the State that additional information is needed before a
    reasonable presumptive deadline can be set.52 That said, we have no difficulty in finding
    that the delay that occurred in J.K.’s case is “far beyond any constitutional boundary.”53
    Here, the defendant was charged with a misdemeanor, for which the initial commitment
    was discretionary, not mandatory. Moreover, it was apparent at arraignment that J.K.
    was suffering from a severe mental illness for which civil commitment would likely be
    appropriate. It was also apparent from the competency evaluation that J.K. had a low
    likelihood of regaining competency in the foreseeable future. And finally, it was
    51
    J.K. filed his second motion to dismiss on November 26, 2018, at which time he had
    been committed for restoration without treatment for 103 days. The court denied the motion
    on January 30, 2019, at which time he had been committed for restoration without treatment
    for 168 days. After this petition was filed, the State initiated civil commitment proceedings
    and dismissed J.K.’s criminal case without prejudice, at which time J.K. had been committed
    for restoration without treatment for 173 days.
    52
    See Powell, 168 A.3d at 876 (noting that courts that have set a deadline have
    “generally had the benefit of a detailed record after a trial or evidentiary hearing”).
    53
    See Terry, 
    232 F. Supp. 2d at 944
    .
    – 22 –                                     2670
    apparent within days of the issuance of the commitment order that J.K. was unlikely to
    be transferred to API within a reasonable time and that he was likely to languish in jail,
    further decompensating mentally, for most, if not all, of the 90-day commitment order.
    Under these circumstances, it was incumbent upon the trial court to take
    action to remedy what was a clear violation of J.K.’s constitutional rights. The amount
    of time that this seriously mentally ill defendant remained in jail awaiting competency
    restoration treatment is unacceptable.
    In the briefing before this Court, the parties suggest that a special master
    be appointed to hear evidence and make factual findings on the many issues relating to
    the delays in admission for restoration treatment so that a presumptive time limit can be
    set for these types of cases. We conclude that a special master appointment is not
    currently needed because there is already ongoing litigation in the trial courts that
    appears to be directed at solving this problem.54
    In the interim, we urge trial courts to be vigilant in ensuring that defendants
    who have been found to be incompetent are not left languishing in jail and that the nature
    and duration of their commitment bear a reasonable relationship to the purpose for which
    the defendant is committed.55
    54
    See Neakok v. State, Trial Court No. 3AN-18-10547 CI.
    55
    See Jackson v. Indiana, 
    406 U.S. 715
    , 738 (1972).
    – 23 –                                       2670